For Therapists: Addressing Sexual Feelings That Arise in Therapy

Sexuality is often a sensitive issue. In recent months, many people have come forward, speaking out about inappropriate, harmful, and abusive sexual behaviors and actions taken by people of positions in greater power. These abuses of power and their effects have too long been in the shadows of silence. The topic of sexuality deserves greater awareness from all of us. By taking the time for honest and open self-reflection, we can all help prevent the misuse of power.

What is inappropriate and harmful sexual activity? For the purposes of clarification, let’s say this includes any physical or verbal behavior that is suggestive, seductive, harassing, demeaning, or exploitative. When a person in therapy is attracted to their therapist, this can often be discussed in therapy without harm—as long as the therapist is not excessively affected by attraction or countertransference. The therapist must be able to focus on the sexual issues of the person in therapy only to the extent such discussion is based on their therapeutic process. It is also essential to establish and uphold boundaries, including an explicit agreement that there is no possibility of sexual relationship at the time or in the future.

Issues related to sexuality present enough challenges in ordinary relationships. When it comes to the therapeutic relationship, sexuality can be even more of a challenging and complex consideration.  Here are some things to consider when examining sexual feelings toward or from people in therapy.

Coping with Sexual Feelings Toward a Person in Therapy

It can first help to explore why you may be attracted to a particular person. Is there something about them that meets one of your needs? Perhaps it is a natural need, but it is one that must be met elsewhere.

  1. Talk to a colleague who can help you sort out what you are experiencing and take appropriate steps to keep the therapeutic relationship ethical.
  2. Seek personal counseling. Working with your own counselor can help you resolve your feelings and uncover any issues in your life you may be struggling to deal with effectively.
  3. If you are unable to resolve your feelings, terminate the professional relationship and refer the person to another therapist.

Coping with Sexual Feelings from a Person in Therapy

A good first step here is to acknowledge the person’s feelings as normal. Appreciate their courage and vulnerability around bringing them up or having them named. Explain that although the intimacy that often develops within the therapeutic relationship is powerful, it is best described as a kind of contextual love that is specific to the power differential relationship. Sexualizing this kind of love is detrimental to your work in therapy.

  1. Make it very clear, with both words and body language, that a sexual relationship is outside the bounds of the therapeutic relationship. (Ethical codes vary in their statements of how long after termination it is considered ethical to begin a sexual relationship, if ever.)
  2. Make every effort not to shame or reject the person you are working with. Track for and attend to any signs of shame or rejection.
  3. If appropriate, look for therapeutic ways in which issue of sexuality can be addressed and explored.
  4. When sexual feelings are unspoken or unconfirmed, use your best professional judgment to determine what would best serve the person you are working with: naming the feelings yourself or waiting for them to make the choice to do so.
  5. Be prepared in advance. Consider how you might handle this kind of situation or how you might handle it with greater skill. Seek the support of supervision.

How Can We Deepen Our Understanding?

The issue of sexuality goes much deeper than simply understanding feelings and setting boundaries. These several questions, brought up by students, can help you explore this topic further in order to deepen your understanding.

Here are a few stories for further consideration:

These stories illustrate how important it is to both think proactively about how you will respond to sexual issues when they arise and to learn how to attend to and repair relationships when needed. When personal sexual desires get involved, thinking can become very warped.

It is especially important to seek out and use resources such as colleagues and supervision when faced with ethical dilemmas, things about which you feel ashamed, or mistakes you have already made or believe you may make. If you are unsure how to begin this process on your own, the support of a compassionate counselor can help.

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